Statin use is associated with a decreased risk of Barrett's esophagus.
Gastroenterology
; 147(2): 314-23, 2014 Aug.
Article
em En
| MEDLINE
| ID: mdl-24798416
ABSTRACT
BACKGROUND & AIMS:
Statins have been associated with a reduced risk of esophageal adenocarcinoma, but little is known about their effect on development of Barrett's esophagus. We evaluated the association between statins and risk of Barrett's esophagus.METHODS:
We conducted a case-control study among eligible patients scheduled for elective esophagogastroduodenoscopy and patients eligible for screening colonoscopy, recruited from primary care clinics at a Veterans Affairs center. We compared 303 patients with Barrett's esophagus with 2 separate sex-matched control groups 606 elective endoscopy controls and 303 primary care controls without Barrett's esophagus. Use of statins and other lipid-lowering medications was ascertained by reviewing filled prescriptions in electronic pharmacy records during a 10-year period before the Barrett's esophagus diagnosis date for patients and study endoscopy date for controls. We calculated odds ratios (OR) and 95% confidence intervals (CI) using conditional multivariable logistic-regression models among 276 patients and 828 controls further matched on age.RESULTS:
A smaller proportion of Barrett's esophagus patients filled statin prescriptions (57.4%) than endoscopy controls (64.9%; P = .029) or primary care controls (71.3%; P < .001). Controls had longer durations of statin prescriptions filled than patients (28.6 vs 22.1 months; P = .001). Statin use was associated with a significantly lower risk of Barrett's esophagus (adjusted OR = 0.57; 95% CI 0.38-0.87) compared with the combined control groups. The risk of Barrett's esophagus was especially lower with statin use among obese patients (OR = 0.26; 95% CI 0.09-0.71), as was the risk for Barrett's esophagus segments ≥ 3 cm (OR = 0.13; 95% CI 0.06-0.30). We found no significant association between Barrett's esophagus and nonstatin lipid-lowering medications (P = .452).CONCLUSIONS:
In a case-control study of veterans, statin use was associated with a reduced risk of Barrett's esophagus. The greatest level of risk reduction was observed for obese patients and for long-segment Barrett's esophagus.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Esôfago de Barrett
/
Inibidores de Hidroximetilglutaril-CoA Redutases
/
Dislipidemias
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article